Cannabis use among older adults: Potential risks and benefits to an aging population

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Project Summary The population of older adults in the U.S. is increasing dramatically, doubling from 48 million to 88 million by the year 2050. As more Americans live longer, the challenge is to assure that quality of life is being maintained along with quantity of life. Research is beginning to focus on understanding the changing physiology underlying normal human aging, as well as expand on behavioral and pharmacological strategies that may assist older adults to maximize their later years, and recent surveys suggest that some may believe that legalized cannabis products have a role to play. Simultaneously, the increasing legalization and acceptance of cannabis is occurring at a rapid pace. Older adults are the fastest growing group of cannabis users in the U.S., with prevalence up by 250% for in some age groups, who perceive virtually no risk of using cannabis monthly (85.3%) or even weekly (79%). National Surveys also showed that older adults were more likely to use cannabis for medicinal purposes than for recreational purposes, and common reasons for use include pain, anxiety, depression, and insomnia. There are obvious and critical questions that this situation poses. First, do older adults experience relief from their symptoms and does this depend on the constituent cannabinoids of the product they are using? Second, are there impacts on neurocognition and motor control that might be harmful, or even potentially beneficial, and do these, too, depend on the cannabinoid profile of the products being used? Third, how can we assist older adults in decision-making regarding cannabis? The overarching goal of this grant application is to leverage our innovative mobile pharmacology laboratory approach and existing aging research infrastructure to better understand the effects of legal market cannabis in adults aged 60 and over. To that end, the proposed research will utilize a prospective, patient-centered observational design to recruit and assess older adults who are interested in using cannabis for pain, trouble sleeping, or negative affect and a comparison group who are not interested in cannabis use. Users will choose and use one of three types of edible cannabis products (i.e., a CBD dominant product, a THC+CBD product, or a THC dominant product) for a total of three months. The proposed research has three aims. First, we will explore the effects of edible cannabis of varying composition among older adults who desire to use cannabis to treat their pain, trouble sleeping, or negative affect (depression/anxiety) as compared to a non-sing comparison group assessed by changes in the Patient Global Impression of Change scale. Second we will explore the effects of edible cannabis use of varying composition on neurocognition and motor control both acutely and over time among older adults. Finally, we will examine the process by which older adult cannabis users decide what type of cannabis product they prefer. Pursuit of these aims has tremendous